This Is Why Black Mothers and Children Are Dying After Birth

Shalon Irving of Sandy Springs, Georgia poses in a nursery while pregnant with her daughter, Soleil. On January 28, 2017, she died from complication of childbirth. Her mother is now raising her daughter. PHOTO: Wanda Irving

I wrote this essay for an English class I took in college. I intended to write it, turn it in, and go about my days. However, the more I’ve read it and sat on it, the more I’ve realized how I should publish it. I mention in the essay just how important it is to bring awareness to this issue in Texas, my home state. Knowing this, I thought to myself, “Why am I hesitant to share?”

I used around 10 sources from The New York Times, The Washington Post, a book called The Mother and Child Project, two peer-reviewed articles from the American Medical Association and the National Library of Medicine, and lastly, articles from the textbook from out class, Bioethics: An Anthology. All sources are less than 5 years old.

Maternal Mortality in Texas—Who Does it Kill?

Maternal mortality, a term used for deaths due to complications from pregnancy or childbirth, in the United States is an issue that is not well funded, well researched, and is often forgotten. Though this issue plagues non-Hispanic white women, its main victim is non-Hispanic black women. Maternal death weighs heavily on the country but weighs even heavier on the state of Texas. This overwhelmingly pro-life state seems to forget about the lost lives of women to the statistics of maternal mortality.

Through research of newspaper articles, peer-reviewed studies, and books, the same question is consistently asked: why? Why black women? And why is no one talking about it? The problem is complex in nature, but simple to understand: the study or article typically ends there, at that question. It does not go deeper into the real issue as to why it is happening and continues to happen to all women, but to black women the worst. The reason, though hard to swallow, is because of the institutional and systemic racism in the health care system, and how it disproportionately affects black women.

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Furthermore, for people to truly understand the nature of this issue, they have to think about the loss of life. A common claim is to have a love for all life, particularly for those who are not yet born. But, we very rarely see their advocacy for women—black women specifically—who have no longer have a life after creating one. If the claim is that life is sacred and should not be taken when it comes to abortion or physician-assisted suicide, then people should also claim that same ideology to the women who die after giving birth.

Let’s get down to statistics…

Though the base of the problem presented is frightening, the statistics regarding maternal death in Texas are even scarier. The maternal death in the state of Texas is still at an all-time high even though women here receive better healthcare than underdeveloped countries. In fact, countries “including Iran and Romania, saw declines [in maternal death]” (Carroll). With our resources not being used towards this issue, the United States maternal death “had increased by more than 25% from 2000 to 2014” while in Texas “from 2011 to 2014, the rate doubled” (Carroll). Although there is a lack of insufficient data to explain these statistics, researchers can come to a conclusion related to a lack of preventative care and family planning.

Texas has historically cut funding to clinics that provided abortions as well as those that provided family planning services, like Planned Parenthood. Christy Turlington Burns writes in The Mother and Child Project about the severity of this issue with her call to action, “We need to make the health and lives of girls and women a priority” (Burns 115). Taking into account that “about 50% of pregnancies in the United States are unplanned,” having these family planning resources for young women is vital (Carroll). This should also be taken seriously particularly if the goal of our majority pro-life legislature is to reduce abortions.

With a failure in abstinence-based education in public schools, the consequence is shown through the number of teen pregnancies in our state. The best way to reduce abortions is not to restrict them, but to instead provide education about safe sex and contraceptives. It is understood that life is seen as sacred, but this should not only be applicable to fetuses.

Can we factor in abortion?

Don Marquis in his article “Why Abortion is Immoral” argues that it is wrong to kill a fetus because it is then “…deprived of all of the value of my future…” (53). Specifically, he argues that the future one would be deprived of is a “future like ours,” which is one full of “activities, projects, experience, and enjoyments which would have otherwise constituted my personal life” (53). Furthermore, Jonathan Glover argues in “The Sanctity of Life” that “…the sanctity of life has to be included among the ultimate principles of any acceptable moral system” (225). Most would agree in terms of abortion or physician-assisted suicide. However, is this not also applicable to pregnant women who are already alive? Why do fetuses get the luxury of a “future like ours” or “sanctity of life” and not the women carrying them? Judith Jarvis-Thomson in her article, “A Defense of Abortion” explains the hypocrisy presented in Marquis and Glover’s arguments with her hypothetical situation of being stuck in an extremely tiny house with a rapidly growing child.

In the scenario, the child is growing at such a rapid pace, the mother will be crushed to death. She writes, “However innocent the child may be, you do not have to wait passively while it crushes you to death. Perhaps a pregnant woman is vaguely felt to have the status of the house, to which we don’t allow the right of self-defense… It cannot seriously be said that she must refrain, that she must sit passively by and wait for her death” (40). In regards to maternal death, however, the “child” can be seen metaphorically as the lack of attention on this issue. Without action, the mother would inevitably die. The disregard for women’s health care is evident, however, the disparity between non-Hispanic black women and white women is even clearer.

Black women in Texas

Some demographics of women in Texas are at much higher rates of maternal mortality. Even with more white women giving birth, more black women are dying. According to Aaron Carroll, “The number of deaths per 100,000 live births among black women is more than 3 times that among white women. In fact, for any state, the higher the percentage of black women in the delivery population, the higher its rates of maternal mortality” (Carroll). This is due in part to the lack of access given to black women to proper, affordable maternal healthcare, particularly in the state of Texas.

Furthermore, the Washington Post points out some demographics regarding black women, reporting that “27 percent of black women live in poverty” and “22 percent [of black women] are uninsured,” black women are at a large disadvantage in the Texas health care system as a whole. Furthermore, “nearly a third of those older than 18 do not see a doctor regularly because of cost” (Murgia). With stunningly high numbers of black women not receiving the care they will need, it is clear that something needs to be done.

Texas Governor Greg Abbott put the issue of maternal death on the agenda along with 19 other issues for the last special session. Though this was made to seem like an important legislative issue, all that was able to be done was to “extend and expand the scope of a task force that started studying the problem a few years ago” (Murgia). The reports that came from this task force showed that between 2010 and 2012, the rates of maternal mortality had doubled, and that “black women were far more likely to become seriously ill and die during pregnancy or within the first year after having a baby” (Murgia). Other than concluding that this is a tragedy for black female Texans, particularly those in poverty, no more legitimate action has been taken to ensure these statistics change. With this conclusion, the same question remains unanswered.

They remain in this state not on the basis of innocent ignorance, but on the basis of controversy. Though people like to believe that “there have been many attempts to explain these pronounced disparities” the reality is the contrary, because the explanation is simple when we examine the relationship between black women and the medical field (Creanga). Historically, black women have been treated horribly by people in the medical profession. In the 20th century, when black women would receive abortions, doctors would sterilize them to avoid giving them the ability to reproduce. With these major setbacks for black women, there is neither equality nor equity when compared to white women.

It’s more than healthcare

It seems as if a number of healthcare professionals don’t like discussing complex issues of racism, because they don’t want to admit that they perpetuate it. Latoya Frazier from The New York Times puts this simply, “people of color, particularly black people, are treated differently the moment they enter the health care system” (Frazier). This is not only applicable in the health care system because black people are treated differently in the workforce, in higher education, and in the criminal justice system. Due to the combined systemic racism and sexism black women endure, their mental and physical health deteriorates. Frazier writes, “For black women in America, an inescapable atmosphere of societal and systemic racism can create a kind of toxic and physiological stress, resulting in conditions – including hypertension and pre-eclampsia – that leads directly to higher rates of infant and maternal death” (Frazier). This should come as no surprise given the history of our country, and even in the state of Texas.

Santhia L. Williams, an African American OB-GYN expresses her concern for inaction, “Actual institutional and structural racism has a big bearing on our patients’ lives, and it’s our responsibility to talk about that more than just saying it’s a problem” (Frazier). Black men and women have always been seen as second-class citizens, but very few know what it feels like. The toll it has on black women is clearly shown through not only maternal mortality but also maternal mental health as well.

Andreea A. Creanga, M.D. and a panel of medical writers explain in their article, “Maternal Mortality and Morbidity in the United States, Where Are We Now?” the effect mental health can have on a pregnancy. “Women suffering from depression are at increased risk of substance abuse, developing chronic diseases and having poorer health” (Creanga). Continuing on, the article states “1 in every 10 women have at least one major depressive episode…” and that “during pregnancy and the post-partum period, women’s poor mental health may adversely impact pregnancy outcomes, maternal-infant bonding, maternal functioning, and infant health and development” (Creanga).

Black women’s stress begins to multiply when they become pregnant. They realize that they themselves are seen as less than, and now the child they are bringing into the world is seen as less than as well. Not only this, but the idea that they could potentially die just a few months after giving birth and not being able to nurture and care for their child, takes a major mental toll on them. A study done on black women’s health by Boston and Howard University verifies the previously mentioned claim adding that “the findings showed higher levels of preterm birth among women who reported the greatest experiences of racism” (Frazier). This cycle seems never-ending, as black women are continuously pushed and generalized with other statistics, which again, leaves important questions about their maternal health unanswered.

An issue with the research of maternal mortality regarding black women is its scarcity. Peer-reviewed articles and books dedicated specifically to black maternal health are few and far between. Black women’s health issues are thrown in the melting pot of general health issues, so the severity of it is not taken seriously. It is in turn seen as one big national struggle. Though there may be some validity to this, it fails to wash away historical racism in the healthcare system. With black women’s maternal health not being taken seriously, we tend to use blanket terms to make it seem as if we’re working on the issue of maternal mortality. Even if time is being dedicated to maternal mortality, it is not being aimed towards black women.

A similar situation that shows the clear disparities of black and white people would be the issue of gun violence. Black people are the victims of gun violence just as people of all races are, but we tend to blanket the term of gun violence in order for change. It seems as if “black” issues mattering is too controversial for comfort, and it is instead more comfortable for people to advocate for issues that impact all. Obviously, no one wants more people dying at the hands of negligent gun owners, but the activism that is put into this issue is not put into the rate at which black people die due to gun violence as well.

Black infant death

The issue of black death starts much sooner than you may think. In fact, The New York Times writes, “Black infants in America are now more than twice as likely to die as white infants – 11.3 per 1,000 black babies, compared with 4.9 per 1,000 white babies” (Frazier). Clearly, just like black maternal death, this issue goes widely unaddressed. Furthermore, this “racial disparity is actually wider than in 1850, 15 years before the end of slavery, when most black women were considered chattel. In one year, that racial gap adds up to more than 4,000 lost black babies” (Frazier).

In the scenarios of maternal death and infant mortality, black women are on the losing team. In some instances, class is taken into consideration. If any person makes a living wage with good health insurance has a baby compared to someone who does not, their child’s chances of survival will be much higher, even when race is taken out of the equation. However, education and income actually offer little protection. In fact “a black woman with an advanced degree is more likely to lose her baby than a white woman with less than an eighth-grade education” (Frazier).

A first-hand example of how class and income do not stop the persistence of this crisis would be that of tennis star Serena Williams. After giving birth to her daughter by C-section last year, she experienced a “pulmonary embolism, the sudden blockage of an artery in the lung by a blood clot” (Frazier). She had previously expressed that “she had a history of this disorder and was gasping for breath, she says medical personnel initially ignored her concerns” (Frazier). Someone of this status should have been able to rely on the medical professionals around her, but they failed her by not taking her requests for help seriously. Serena Williams, just like the millions of black mothers and infants, cannot escape the systemic “-isms” that plague our country time and time again.

Bruce Wilkinson writes in The Mother and Child Project, “Mothers are the cornerstones on which families rest” (105). This is true for black mothers as well. In order for them to be there for their children, they have to physically be there. As we continue to restrict access to family planning and ignore the racism in the health care system, the problem will do nothing but progress.

To conclude…

There seems to be no positive future for black women’s maternal health. The questions seem to remain unanswered all while the funding for family planning centers and women’s health clinics that offer abortions get cut close to nothing. The wall of the pro-life argument continues to come crumbling down as new evidence is provided year after year that proves the inconsistency in their argument. Living women who give birth are not granted a full future in the very realistic event that they die and suggesting that their lives and futures should not be seen as important as that of a fetus.

This topic should not be up for debate nor should it be continuously disregarded as it often is. With black women dying at an alarming rate, legislatures and healthcare professionals will have to address the systemic and institutional racism in the healthcare system. This starts with understanding our history and accepting the things we can no longer change. From there, however, we can make a change. Good, and necessary change for the coming generations of mothers and children. Countries like Iran and Romania are clearly leading the way in progress when it comes to this important issue. However, black maternal death seems to just be the tip of the iceberg to a wealth of issues that disregard black women, another issue being infant mortality.

With the rise every year of over 4,000 black infants dying, we have learned that this is not because the health care has gotten worse in our country, but because the issue of systemic racism has.

Lastly, no call to action seems to be loud enough. There are several, and none seem to shake the walls of our hospitals, research facilities, or legislatures.

1 Comment

Do you honestly believe that healthcare in the middle east comes anywhere close to the healthcare that people in Texas have access to? Have you ever considered that there might be other external factors accounting for alarming levels of African American maternal deaths other than some “systemic racism.” The idea that the whole American healthcare system is involved in systemic racism is ridiculous. Point me to a racism doctor and we can get him fired. Propose some new policy that might protect people of color. Don’t make unverified claims that there is some form of discrimination that is out there in the void. I work in the healthcare field and if you think that someones skin color affects the way the patient is treated than you are delusional. Yes I am aware that many black women face discrimination. However think about this, why would anyone go into the healthcare field? The path is long and hard to get there and the job isn’t all sunshine and rainbows. You have to have a passion to help and serve humankind to be successful in healthcare. I would invite you to rethink your assumption that skin color is the driving force behind the statistics you’re analyzing. Maybe, just maybe, income has something to do with it and the percentage of single mothers.